MEDICARE: MORTON J ROSENBERG RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP024044L	PA

General Provider Information

NPI Number	:	1174647937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORTON J ROSENBERG RPH

Provider Business Mailing Address
First Line	:	3220 AYR LN
Second Line	:
City	:	DRESHER
State	:	PA
Zip	:	19025-1604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2848 W LEHIGH AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19132-3130
Country	:	US
Telephone Number	:	215-228-7177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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